摘要
糖尿病足溃疡是糖尿病严重的破坏性并发症,致残率及致死率逐年增高,严重威胁人类身心健康。中医药治疗糖尿病足溃疡,注重辨证论治与整体观念相结合,不仅能改善中医证候,更能在加速创面愈合的同时减少创面的复发,一定程度上延缓了糖尿病足溃疡的进一步恶化,降低其致残率及致死率。现代研究发现,糖尿病足溃疡难以愈合与各种细胞因子如炎症因子、生长因子、趋化因子等分布异常密切相关;随着现代医学对中医药研究的不断深入,中药单体及复方调控细胞因子治疗糖尿病足溃疡已成为研究热点,该文通过对目前国内外研究现状进行归纳,得出以下总结:(1)芝麻酚、栀子苷、当归补血汤、紫朱软膏等调节肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1、IL-6、IL-10等炎症因子,抑制创面炎症。(2)白芷、丹酚酸B、四效散、壮药拔毒生肌膏等调节血管内皮生长因子(VEGF)、血小板衍生生长因子(PDGF)、转化生长因子(TGF)、表皮生长因子(EGF)等生长因子,促进创面胶原沉积及血管新生。(3)芍药苷、隐丹参酮、蜂毒、回阳生肌汤等调节CXC趋化因子配体(CXCL)1、CXCL2、CC趋化因子配体(CCL)2、CCL3、基质细胞衍生因子-1α(SDF-1α)、单核细胞趋化因子-1(MCP-1)等趋化因子,降低炎症反应,促进新生血管形成及创面肉芽组织形成。(4)中药单体及复方在治疗糖尿病足溃疡的过程中,其作用机制虽有所侧重但并非简单的单一对应,中医药多靶点的特点决定了其可作用于多种细胞因子以参与创面愈合的各个阶段从而发挥治疗作用。以上总结旨在为今后中医药治疗糖尿病足溃疡的实验研究及临床治疗提供思路。
Diabetic foot ulcer is a serious and destructive complication of diabetes,with the rates of disability and mortality increasing year by year,which poses a serious threat to human physical and mental health.In the treatment of diabetic foot ulcer with traditional Chinese medicine(TCM),the combination of syndrome differentiation and overall concept can not only alleviate TCM syndrome but also accelerate wound healing,reduce wound recurrence,delay the further deterioration of diabetic foot ulcer,and decrease the rates of disability and mortality.Modern studies have demonstrated that the difficult healing of diabetic foot ulcer is closely associated with the abnormal distribution of cytokines such as inflammatory cytokines,growth factors,and chemokines.With the deepening of modern medical research on TCM,the treatment of diabetic foot ulcer via regulation of cytokines by Chinese medicinal monomers and prescriptions has become a research focus.This paper summarizes the current research status at home and abroad and draws the following conclusions.(1)Sesamol,geniposide,Danggui Buxuetang,and Zizhu ointment can regulate tumor necrosis factor-α(TNF-α),interleukin(IL)-1,IL-6,IL-10 and other inflammatory cytokines to inhibit wound inflammation.(2)Angelicae Dahuricae Radix,salvianolic acid B,Sixiao powder,Badu Shengji ointment(Zhuang medicine),etc.,regulate vascular endothelial growth factor(VEGF),platelet-derived growth factor(PDGF),transforming growth factor(TGF),epidermal growth factor(EGF)and other growth factors to promote collagen deposition and angiogenesis on wound surface.(3)Paeoniflorin,cryptanshinone,bee venom,and Huiyang Shengji decoction regulate CXC chemokine ligand(CXCL)1,CXCL2,C-C chemokine ligand(CCL)2,CCL3,stromal cell-derived factor-1α(SDF-1α),monocyte chemoattract protein-1(MCP-1)and other chemokines to reduce inflammatory response and promote neovascularization and wound granulation tissue formation.(4)In the treatment of diabetic foot ulcer,Chinese medicinal monomers and prescriptions have different
作者
郭夏晴
杜娟娇
叶世青
王茜茜
曹妍
陈仲件
许东敏
杨莹
GUO Xiaqing;DU Juanjiao;YE Shiqing;WANG Xixi;CAO Yan;CHEN Zhongjian;XU Dongmin;YANG Ying(Guangxi University of Chinese Medicine,Nanning 530001,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2023年第3期263-272,共10页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(81360572)。
关键词
中医药
糖尿病足溃疡
细胞因子
炎症因子
生长因子
趋化因子
traditional Chinese medicine
diabetic foot ulcer
cytokine
inflammatory cytokine
growth factor
chemokine
